<!DOCTYPE html>
<html lang="en">
  <head>
    <title>Simple form</title>
  </head>

  <body>
    <form action="url_to_send_form_data" method="post">
      <fieldset>
        <div>
          <label for="title">Title:</label><br />
          <select id="title">
            <option value="Mr">Mr</option>
            <option value="Mrs">Mrs</option>
            <option value="Ms">Ms</option>
            <option value="Miss">Miss</option>
          </select>
        </div>
        <div>
          <label for="first_name">First name:</label><br />
          <input id="first_name" type="text" name="firstname" />
        </div>
        <div>
          <label for="last_name">Last name:</label><br />
          <input id="last_name" type="text" name="lastname" />
        </div>
        <div>
          <label for="message">Message: </label><br />
          <textarea id="message" rows="5" cols="20"></textarea>
        </div>
        <button type="submit">Submit</button>
      </fieldset>
    </form>
  </body>
</html>
